This op-ed was originally published in the Australian Financial Review on February 19, 2020.
The novel coronavirus COVID-19 may become a footnote in history – a disaster narrowly averted. It could also become a global pandemic similar to some of the worst pandemics of the twentieth century.
For example, assume the COVID-19 is as easy to spread and as dangerous as the 1957 Asian flu. Based on the epidemiological estimates of mortality and morbidity rates from that experience, our best estimate from a 2006 study on pandemics was that such a virus might kill more than 14 million people and shrink global GDP by more than $500 billion (McKibbin and Alexandro Sidorenko. Global macroeconomic consequences of pandemic influenza. Australian National University, 2006). These estimates are far higher than the costs were in 1957 because our world is increasingly connected and urban. Preliminary results currently being updated in 2020 suggest even higher numbers for worse case COVID-19.
We hope that scientists can rapidly develop a vaccine. Unfortunately, there is much we do not yet know about this new virus.
At the same time, we do know the virus mostly spreads when people sneeze or cough. The germs then spread when people inhale infected droplets. The germs also land on surfaces. People who touch their own mucus or an infected surface then spread the virus on their hands. For most respiratory infections, perhaps half the cases spread from people’s hands.
Fortunately, even without a vaccine, we already know how to slow an epidemic of respiratory infections.
If everyone coughed or sneezed into their elbow or a tissue (not into the air or on their hands), the germs would not travel very far. And if everyone washed hands with soap before preparing food or eating, that route of transmission would end.
Thus, an immediately effective response would be for each government to start a crash national program to disseminate these safe behaviors.
Most people consider it disgusting if someone does not wash hands with soap after a bathroom visit. National governments should work to extend this norm. We want a norm that someone is spreading disgusting bodily fluids and dangerous germs if they do not wash hands with soap after sneezing and before eating. Public service announcements and school curriculums can reinforce these attitudes. And all primary schools should immediately implement routines for handwashing before meals.
These actions can help make people in all countries dramatically safer. At the same time, no single nation can protect itself from a global pandemic. Unfortunately, many low-income nations lack resources to disseminate these safe behaviors. Rich nations should work together to subsidize the rapid deployment of hygiene interventions around the globe. Any school, hospital or family that adopts these safe behaviors makes us all a bit safer.
This COVID-19 epidemic may eventually end, even without these interventions. Even so, increased handwashing substantially reduces diarrheal diseases and serious respiratory infections with enormous social and economic benefits particularly in poor countries. Thus, policies to increase good hygiene, which were cost-effective before today’s risk of a new pandemic, are clearly more important to reduce the risk of global pandemics. Given the clear disruption the global economy, a small investment in these interventions are the most cost-effective response to the current outbreak. They are also a long term insurance policy against future disease outbreaks that threaten people in all countries.
The authors did not receive financial support from any firm or person for this article or from any firm or person with a financial or political interest in this article. Neither is currently an officer, director, or board member of any organization with a financial or political interest in this article.